Pelvic Musculature, Vasculature, Lymphatics, And Nerves

Front 1

what is the shape of the true pelvis?

Back 1

bowl shape

Front 2

what are the 2 triangles which compose the perineum?

Back 2

anal triangle and urogenital triangle

Front 3

what is the name for the fascia in the pelvis which is a continuation of the transversalis fascia in the abdomen?

Back 3

endopelvic fascia

Front 4

which muscle is responsible for cushioning the posterolateral body sidewall of the pelvis? The anterolateral sidewall?

Back 4

piriformis; obturator internus

Front 5

where does the piriformis muscle originate? Through where does it leave the pelvis? Where does it insert?

Back 5

between the anterior foramina of the sacrum; through the greater sciatic foramen; on the greater trochanter of the femur

Front 6

where does the obturator internus originate?

Back 6

along the bony structures surrounding the obturator foramen and from the obturator membrane itself

Front 7

how does the obturator internus muscle exit the pelvis?

Back 7

through the lesser sciatic foramen

Front 8

which muscle of the pelvis also lines part of the perineum?

Back 8

obturator internus

Front 9

which aspect of the perineum does the obturator internus form?

Back 9

the lateral wall of the ischioanal fossa

Front 10

which muscle divides the obturator internus into pelvic and perineal portions?

Back 10

iliococcygeus

Front 11

what is the path of the obturator internus after it passes through the lesser sciatic notch?

Back 11

it burnishes the lesser sciatic notch and changes direction larterally to head for its insertion on the greater trochanter of the femur

Front 12

which two muscles of the pelvis can rightfully be called muscles of the lower extremity?

Back 12

obturator internus and piriformis

Front 13

what are the names of the two muscles which compose the levator ani of the pelvis?

Back 13

pubococcygeus and iliococcygeus

Front 14

what are the two aspects of the pelvic diaphragm?

Back 14

levator ani and coccygeus

Front 15

which muscle, obturator internus or piriformis inserts more superiorly on the greater trochanter?

Back 15

piriformis

Front 16

which muscle of the pelvis splits the greater sciatic forman into two compartments?

Back 16

piriformis

Front 17

which foramen of the pelvis does the pelvic diaphragm split in half?

Back 17

obturator foramen

Front 18

what is the origin of the pubococcygeus? The insertion?

Back 18

back of body of pelvis; coccyx

Front 19

what is the name for the gap between the two sides of the pubococcygeus?

Back 19

urogenital hiatus

Front 20

with what is the urogenital hiatus filled?

Back 20

perineal membrane

Front 21

what passes through the urogenital hiatus?

Back 21

urethra and vagina

Front 22

does the rectur pass through the pelvic diaphragm anterior or posterior to the urogenital hiatus?

Back 22

posterior

Front 23

the coccygeus muscle of the pelvis lies over which structure of the pelvis?

Back 23

sacrospinous ligament

Front 24

posterior to the anal aperture, what happens to the pubococcygeus muscle of the pelvic diaphragm?

Back 24

comes together as a ligament called the anococcygeal raphe which attaches to the coccyx

Front 25

what is the name for the part of the pubococcygeus muscle which forms a sling around the terminal part of the gastrointestinal tract?

Back 25

puborectalis

Front 26

what is the name for the GI tract at the passage of the puborectalis muscle?

Back 26

anorectal junction

Front 27

the anococcygeal raphe extends from where to where in the pelvis?

Back 27

anus to coccyx

Front 28

what is the name for the muscle of the levator ani which lies lateral to the pubococcygeus? Where does it originate? Insert?

Back 28

iliococcygeus; tendinous arch; ischial spine

Front 29

what happens to the iliococcygeus muscle after it passes around the snorectal junction?

Back 29

comes together from both sides as a midline raphe which is continuous with the fibroelastic anocyccygeal raphe and inserts on coccyx

Front 30

where does the coccygeus originate? Insert?

Back 30

ischial spine; distal sacrum and coccyx

Front 31

what is the perineal body?

Back 31

connective tissue structure positioned in the midline of the perineum extending from the anus to the vagina

Front 32

is there a fascia surrounding the levator ani? Superior or inferior?

Back 32

yes; both superior and inferior fascia

Front 33

which aspect of the levator ani acts as the lateral compressor of the viscera (urethra, vagina, rectum) that traverse the pelvic floor?

Back 33

pubococcygeus

Front 34

which aspect of the levator ani helps create the anorectal angle? What is the measurement of this angle? What is its role?

Back 34

puborectalis; 80 degrees; maintaining anorectal continence

Front 35

contraction of the pelvic diaphragm results in what?

Back 35

increase in intra-abdominal pressure

Front 36

does the puborectalis contract or relax to permit urination and defecation?

Back 36

relax

Front 37

which muscle of the pelvic diaphragm is the remnant of the tail wagging muscle in animals with tails?

Back 37

coccygeus

Front 38

what are the 2 branches of the external iliac artery?

Back 38

deep circumflex iliac artery and inferior epigastric artery

Front 39

what is the name of the external iliac artery following its passage under the inguinal ligament?

Back 39

femoral artery

Front 40

which artery and its branches supplies the main blood supply to the pelvis, buttock, and perineum?

Back 40

internal iliac arteries

Front 41

what is the name of the artery in the pelvis which supplies blood to the rectum? This is the terminal branch of which artery?

Back 41

superior rectal artery; inferior mesenteric artery

Front 42

what is the name for the artery to the eplvis which travels anterior to the sacrum in the midline? From where does this artery arise?

Back 42

median sacral artery; posterior aspect of the distal aorta

Front 43

what is the name for the artery which supplies blood to the arteries? Through where does it arrive at the ovaries?

Back 43

ovarian arteries; suspensory ligaments of the ovaries

Front 44

what are the names of the two divisions of the internal iliac artery?

Back 44

posterior and anterior divisions

Front 45

what are the names of the 3 parietal branches of the posterior division of the internal iliac artery? Of these 3, which supply blood to the pelvic wall? Which supply the buttock?

Back 45

iliolumbar, lateral sacral, superior gluteal; iliolumbar and lateral sacral; superior gluteal

Front 46

what are the names of the 3 parietal branches of the anterior division of the internal iliac artery? Which supplies blood to the buttock? To the lower extremity? To the perineum?

Back 46

inferior gluteal, obturator artery, and internal pudendal artery; inferior gluteal; obturator artery; internal pudendal artery

Front 47

what is the name of the artery in the anterior division of the internal iliac artery which arises from the umbilical artery in the fetus? What does it supply?

Back 47

superior vesical artery; superior aspect of the bladder and distal parts of the ureters

Front 48

what is the name of the artery in the anterior division of the internal iliac artery which exists only in men? What does it supply?

Back 48

inferior vesical artery; bladder, ureter, seminal vesicles, and prostate

Front 49

what is the name for the female equivalent of the inferior vesical artery in men? What does it supply?

Back 49

vaginal artery; branches to vagina and to adjacent parts of bladder and rectum

Front 50

what is the name for the artery in the anterior division of the internal iliac artery which supplies blood to the rectum?

Back 50

middle rectal artery

Front 51

in order from superior to inferior, what is the order with which the obturator artery, nerve, and vein enter the obturator canal?

Back 51

obturator nerve, obturatory artery, obturator vein

Front 52

what is the name of the artery in females which courses medially and anteriorly in the base of the broad ligament to reach the cervix?

Back 52

uterine artery

Front 53

which artery is the major source of blood to the uterus?

Back 53

uterine artery

Front 54

with which artery of the aorta does the lateral sacral artery anastomose?

Back 54

lateral sacral

Front 55

with which artery of the aorta does the middle rectal artery anastomose?

Back 55

superior rectal

Front 56

with which artery of the aorta does the uterine artery anastomose?

Back 56

ovarian

Front 57

with which artery of the aorta does the artery of the vas deferens anastomose?

Back 57

testicular artery

Front 58

the artery of vas deferens is a branch of which artery in men?

Back 58

suprior vesical

Front 59

with which artery of the aorta does the iliolumbar artery anastomose?

Back 59

lumbar artery

Front 60

pelvic veins follow the course of all branches of the internal iliac arteries except which two arteries?

Back 60

umbilical artery and iliolumbar artery

Front 61

the internal iliac veins join the common iliac veins inferior or superior to the pelvic inlet?

Back 61

superior

Front 62

veins from visceral pelvic plexuses converge to form which vein?

Back 62

internal iliac vein

Front 63

the internal iliac vein joins the external iliac to form the common iliac vein just anterior to which joint?

Back 63

sacroiliac joint

Front 64

which vein of the pelvis enters into the hepatic portal venous system?

Back 64

superior rectal vein

Front 65

how does the pelvic plexus come into play during a blocked hepatic portal system?

Back 65

shunting via pelvic plexus to IVC

Front 66

what are the 3 arteries which enter the spermatic cord? What are their respective sources?

Back 66

testicular artery, artery to vas deferens, cremasteric artery

Front 67

when doing uterine surgery in females, what must one be cognizant of when dealing with ovarian and uterine arteries?

Back 67

injury to the ureters

Front 68

are iliac veins posterior or anterior to their arterial counterparts?

Back 68

posterior

Front 69

how can blood enter the internal vertebral venous plexus from the pelvis?

Back 69

by draining retrograde through the lateral sacral veins

Front 70

lymphatics from the pelvis and most of pelvic viscera drain into nodes located where?

Back 70

along internal iliac, external iliac, and their branches

Front 71

the drainage from the superficial and deep inguinal nodes drain into which node network?

Back 71

external iliac nodes

Front 72

where does lymph from the superior half of the rectum drain? Lymph from the gonads?

Back 72

directly to pre-aortic nodes; directly to the para-aortic lymph notes

Front 73

what are the names of the veins in the abdomen into which vertebral veins drain?

Back 73

lumbar veins

Front 74

the lumbosacral trunk arises from which spinal nerves?

Back 74

part of L4 and all of L5 VPR

Front 75

the femoral nerve arises from which spinal nerve VPR's? obturator nerve?

Back 75

L2-4; L2-4

Front 76

the sacral plexus arises from the VPR's of which spinal nerves?

Back 76

part of L4, L5-S4

Front 77

what are the two major nerves of the sacral plexus?

Back 77

sciatic and pudendal

Front 78

what does the sciatic nerve innervate?

Back 78

muscles of the posterior compartment of the thigh, all the muscles of the leg and foot, skin of the foot, and much of the leg

Front 79

where does the sciatic nerve form? Through where does it pass?

Back 79

on the anterior surface of the piriformis muscle; through the greater sciatic foramen inferior to the piriformis

Front 80

what does the pudendal nerve innervate?

Back 80

main nerve of the perineum and chief nerve of the external genitalia

Front 81

in addition to innervation provided by sciatic and pudendal nerve, what does the sacral plexus innervate?

Back 81

sensation to skin of distal buttock and down back of thigh and motor innervation of muscles of the buttock, pelvic diaphragm and all the muscles that exit the pelvis and go to the hip

Front 82

what are the divisions of the sacral plexus? What do these innervate?

Back 82

anterior and posterior divisions; embryologically derived anterior (flexion/adduction) and posterior (extendion/abduction) muscles, respectively

Front 83

anterior derived muscles below the hip are located where in the adult lower extremity? The posteriorly derived muscles?

Back 83

posteriorly; anteriorly

Front 84

sympathetic innervation to the pelvis is primarily from which nerves? From which spinal cord levels are these nerves derived?

Back 84

lumbar splanchnic; T10-L2

Front 85

lumbar splanchnics travel where from their exit from the sympathetic chain?

Back 85

travel medially to form the superior hypogastric plexus in front of aorta and sacral promontory

Front 86

from the superior hypogastric plexus, where do the sympathetic nerves course?

Back 86

along the lateral pelvic walls to the pelvic plexus

Front 87

what is another name for the pelvic sympathetic plexus?

Back 87

inferior hypogastric plexus

Front 88

which nerve plexuses are found distal the inferior hypogastric plexus?

Back 88

middle rectal, vesical, prostatic, uterovaginal

Front 89

parasympathetic nerves to the pelvis arise from which spinal cord levels? What do they travel as through the pelvic plexus?

Back 89

S2-4; pelvic splanchnic nerves

Front 90

how do parasympathetic nerves reach the external genitalia?

Back 90

by traveling beneath the pubic arch

Front 91

what is the role of sympathetic sacral splanchnics?

Back 91

they are of little importance

Front 92

afferent pain fibers travel back to spinal cord with which nerves?

Back 92

sympathetic and parasympathetic

Front 93

sympathetic lumbar splanchnics synapse where? Sympathetic pelvic splanchnics?

Back 93

pre-aortic ganglia; pelvic plexus

Front 94

what happens to sympathetic nerves that descend and synapse in the sacral sympathetic chain ganglia?

Back 94

Postganglionic fibers join spinal nerves from the sacral plexus to supply buttock, perineum and lower extremity